The present invention relates generally to endoscopes and, more particularly, to steerable/articulate and swappable endoscopes for performing robotic surgery.
Advances in minimally invasive surgical technology could dramatically increase the number of surgeries performed in a minimally invasive manner. Minimally invasive medical techniques are aimed at reducing the amount of extraneous tissue that is damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and deleterious side effects. The average length of a hospital stay for a standard surgery may also be shortened significantly using minimally invasive surgical techniques. Thus, an increased adoption of minimally invasive techniques could save millions of hospital days, and millions of dollars annually in hospital residency costs alone. Patient recovery times, patient discomfort, surgical side effects, and time away from work may also be reduced with minimally invasive surgery.
The most common form of minimally invasive surgery may be endoscopy. Probably the most common form of endoscopy is laparoscopy, which is minimally invasive inspection and surgery inside the abdominal cavity. In standard laparoscopic surgery, a patient's abdomen is insufflated with gas, and cannula sleeves are passed through small (approximately ½ inch) incisions to provide entry ports for laparoscopic surgical instruments. The laparoscopic surgical instruments generally include a laparoscope (for viewing the surgical field) and working tools. The working tools are similar to those used in conventional (open) surgery, except that the working end or end effector of each tool is separated from its handle by an extension tube. As used herein, the term “end effector” means the actual working part of the surgical instrument and can include clamps, graspers, scissors, staplers, and needle holders, for example. To perform surgical procedures, the surgeon passes these working tools or instruments through the cannula sleeves to an internal surgical site and manipulates them from outside the abdomen. The surgeon monitors the procedure by means of a monitor that displays an image of the surgical site taken from the laparoscope. Similar endoscopic techniques are employed in, e.g., arthroscopy, retroperitoneoscopy, pelviscopy, nephroscopy, cystoscopy, cistemoscopy, sinoscopy, hysteroscopy, urethroscopy and the like.
There are many disadvantages relating to current minimally invasive surgical (MIS) technology. For example, existing MIS instruments deny the surgeon the flexibility of tool placement found in open surgery. Most current laparoscopic tools have rigid shafts, so that it can be difficult to approach the worksite through the small incision. Additionally, the length and construction of many endoscopic instruments reduces the surgeon's ability to feel forces exerted by tissues and organs on the end effector of the associated tool. The lack of dexterity and sensitivity of endoscopic tools is a major impediment to the expansion of minimally invasive surgery.
Minimally invasive telesurgical robotic systems are being developed to increase a surgeon's dexterity when working within an internal surgical site, as well as to allow a surgeon to operate on a patient from a remote location. In a telesurgery system, the surgeon is often provided with an image of the surgical site at a computer workstation. While viewing a three-dimensional image of the surgical site on a suitable viewer or display, the surgeon performs the surgical procedures on the patient by manipulating master input or control devices of the workstation. The master controls the motion of a servomechanically operated surgical instrument. During the surgical procedure, the telesurgical system can provide mechanical actuation and control of a variety of surgical instruments or tools having end effectors such as, e.g., tissue graspers, needle drivers, or the like, that perform various functions for the surgeon, e.g., holding or driving a needle, grasping a blood vessel, or dissecting tissue, or the like, in response to manipulation of the master control devices.
While minimally invasive surgical robotic systems such as the da Vinci® from Intuitive Surgical Inc. of Sunnyvale, Calif. can provide surgeons with much more articulation and much improved quality 2D and 3D video images during surgeries than conventional laparoscopy, currently such surgical robotic systems may be more limited in terms of flexibility in certain functions. In particular, due to their size and weight, a surgical robot architecture with a “dedicated” robot arm is required to hold the endoscope and its camera heard such as that described in U.S. Pat. No. 6,451,027. As a result, surgeons cannot exchange the endoscope between ports as typically occurred in conventional laparoscopy. Moreover, the size and weight of the endoscope causes difficulty in dismounting and manually maneuvering the endoscope especially to see difficult-to-reach or hidden areas. This loss of flexibility means that while minimally invasive surgical robotic systems excel in difficult reconstructive surgeries in confined areas such as the heart and pelvis, they become less applicable for procedures involving access to large anatomical areas (e.g., multiple quadrants of the abdomen) and/or access from different directions.
Furthermore, current robotic endoscopes are rigid, pointing either straight ahead (i.e., zero (0) degree angle) or at a thirty (30) degree angle from the long axis of the endoscope which allows the surgeon to more easily look down or up. Consequently, during many surgical procedures, the surgeon may require to switch back and forth numerous times between a straight ahead scope and a thirty-degree scope to obtain different perspectives inside the surgical site. Such scope switching increases the surgical procedure's duration, operational and logistic complexity, and even safety concerns. However, even with scope switching, the surgeon is still limited to only a few visual perspectives and therefore a smaller area of visibility. Additionally, the surgeon may yet be prevented from getting a desired view of the body tissues that are hidden around obstacles (e.g., during gynecological procedures) or between tissue that requires some tunneling (e.g., during atrial fibrillation or endoluminal diagnosis and treatment).
Thus, a need exists for a surgical robotic endoscope system and method that allows for simplification of future surgical robot architectures, provides more flexible port placement, provides a greater area of visibility, provide multiple visual perspectives without added operational and logistic complexity or safety concerns, and provides the most desirable view of hidden body tissues.